Table 2.

Demographics and Outcomes of Participants in the Identified Studies.

Study reference	Pt age, mean a years; female sex (%)	Pt adherence	Confidence ratings	Pt preference outcomes	Other outcomes
Adolfsson et al 17	Median 12.0; 47.5	• Proportion of children reporting self-injection with NovoPen Echo was higher than those using their previous device (71% vs 66%; p = .006) • Proportion of pts reporting forgotten injections was significantly lower (27% vs 51%; p < .0001)	• Confidence increased: more pts reported the NovoPen Echo increased their confidence about not missing injections (85.9%) and managing daily injections (73.3%) (both p < .0001)	• 75.7% found NovoPen Echo better looking; easier to depress (72.7%), prepare (70.7%), and use for injection (71.1%); and easier to use overall (75.1%) than their previous device (all p < .0001)	• Mean HbA1c increased from 8.4% to 8.6% during the study. Proportion of pts achieving HbA1c <7.5% decreased (23.4% vs 17.8%) • Major hypoglycemic events reported in the four weeks prior decreased from 6.3% of pts using NovoPen Echo vs 10% (335.3 events per 100 PY) with previous devices
Asakura and Jensen 18	61.9; 42.6	NR	• Confidence in setting and injecting the correct dose was extremely important in 44% and 48% of pts, respectively	• 82% of pts preferred FlexPen over OptiClik	• FlexPen vs OptiClik, required less instruction time and was rated as simpler to use (82% vs 12%; p < .001) and more convenient (71% vs 12%; p < .001)
Cerna and Maresova 19	NR (48.6% aged >50); 57.8	NR	NR	NR	• Pts had a low level of knowledge about using technologies for diabetes treatment • Only 25% of pts knew of any diabetes-related apps • Positive correlation between technical skills and methods of entering data
Danne et al 20	39.8; NR	NR	NR	• 76.7% and 78.1% of pts were mostly or definitely willing to continue using the HumaPen Memoir or the HumaPen Luxura, respectively	• No significant difference between the two insulin pens regarding mean change in HbA1c up to week 24 • Overall incidence of hypoglycemia was not significantly different between the two insulin pen treatment groups • Memory function of the smart insulin pen might be helpful for certain pt populations, eg, children or forgetful pts
Gomez-Peralta et al 15	NA; NA	NA	NA	NA	• 97% of injections performed were correctly detected • Relative error was 2.9%-6.8% for dose accuracy detection across all dose groups • Strong correlation between time detected by Insulclock and an external chronometer (R2 = 0.99) and a correlation between temperatures detected by Insulclock and an external thermometer (R2 = 0.90)
Guo et al 21	49.8; 54.0	NR	• More pts would be “very confident” using NovoPen 5 (64%) vs HumaPen Memoir (43%), HumaPen Luxura (49%), and ClikSTAR (45%) • For use of a pen with memory function vs a conventional pen: 46% of pts would be “very confident”	• 49% of pts preferred NovoPen 5	• Significant differences between NovoPen 5 and other pens with respect to design, ease of learning, and confidence
Klausmann et al 23	NR (65% aged 31-64); 50.0	NR	• Significantly more pts would have more confidence using the NovoPen 5 for managing daily injections vs HumaPen Luxura (82 vs 11%; p < .001)	• Significantly more pts preferred the NovoPen 5 to the HumaPen Luxura (82% vs 17%; p < .001)	• Pts indicated the memory function would be most helpful with increasing confidence about timing and amount of their last insulin dose • Pts gave higher ratings to NovoPen 5 than to HumaPen Luxura on ease of handling, satisfaction, convenience for daily use, pen quality, and extent to which the pen met their needs (p < .05 for all)
Olsen et al 24	NR (56% aged 13-18); 52.0	NR	• Feeling secure regarding complete injection of the dose contributed to participants’ overall high satisfaction with the NovoPen Echo	• 80% of participants preferred NovoPen Echo (vs 7% and 12% for NovoPen Junior and HumaPen Luxura; both p < .0001) • 74% of pediatric pts, 88% of parents favored NovoPen Echo	• Features of the NovoPen Echo that may lead to successful use in the pediatric setting include the simple memory function, half-increment units, ease of use, and options for appearance customization
Venekamp et al 25	51.7; 42.0	NR	NR	• 81.4% of pts preferred HumaPen Memoir over their pre-study device	• No serious concerns regarding functionality of HumaPen Memoir • Where differences between HumaPen Memoir and the pre-study device were significant (p < .05), the majority favored the HumaPen Memoir • HumaPen Memoir was considered easier and more convenient to use than the pre-study device • Glycemic control was maintained; hypoglycemic events reported were not considered related to the HumaPen Memoir

^aUnless otherwise noted.

Abbreviations: HbA1c, glycosylated hemoglobin; NA, not applicable; NR, not reported; pt(s) patient(s); PY, patient-years; R², coefficient of determination.